Burden, determinants, consequences and care of multimorbidity in rural and urbanising Telangana, India: protocol for a mixed-methods study within the APCAPS cohort

Judith Lieber, Santosh Kumar Banjara, Poppy Alice Carson Mallinson, Hemant Mahajan, Santhi Bhogadi, Srivalli Addanki, Nick Birk, Wenbo Song, Anoop SV Shah, Om Kurmi, Gowri Iyer, Sureshkumar Kamalakannan, Raghu Kishore Galla, Shilpa Sadanand, Teena Dasi, Bharati Kulkarni, Sanjay Kinra

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Abstract

Introduction: The epidemiological and demographic transitions are leading to a rising burden of multimorbidity (co-occurrence of two or more chronic conditions) worldwide. Evidence on the burden, determinants, consequences and care of multimorbidity in rural and urbanising India is limited, partly due to a lack of longitudinal and objectively measured data on chronic health conditions. We will conduct a mixed-methods study nested in the prospective Andhra Pradesh Children and Parents' Study (APCAPS) cohort to develop a data resource for understanding the epidemiology of multimorbidity in rural and urbanising India and developing interventions to improve the prevention and care of multimorbidity.

Methods and analysis: We aim to recruit 2100 APCAPS cohort members aged 45+ who have clinical and lifestyle data collected during a previous cohort follow-up (2010-2012). We will screen for locally prevalent non-communicable, infectious and mental health conditions, alongside cognitive impairments, disabilities and frailty, using a combination of self-reported clinical diagnosis, symptom-based questionnaires, physical examinations and biochemical assays. We will conduct in-depth interviews with people with varying multimorbidity clusters, their informal carers and local healthcare providers. Deidentified data will be made available to external researchers.

Ethics and dissemination: The study has received approval from the ethics committees of the National Institute of Nutrition and Indian Institute of Public Health Hyderabad, India and the London School of Hygiene and Tropical Medicine, UK. Meta-data and data collection instruments will be published on the APCAPS website alongside details of existing APCAPS data and the data access process (www.lshtm.ac.uk/research/centres-projects-groups/apcaps).
Original languageEnglish
Article numbere073897
Number of pages12
JournalBMJ Open
Volume13
Issue number11
DOIs
Publication statusPublished - 27 Nov 2023

Bibliographical note

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

Funder

This work was primarily supported by the UK Medical Research Council (MRC) grant number MC_PC_MR/T038292/1. This research was also part funded by MRC grant number MR/V001221/1, the Nagasaki University 'Doctoral Program for World-leading Innovative and Smart Education' for Global Health, KENKYU SHIDO KEIHI and in-kind support from ICMR-NIN.

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